Trends in Contraceptive Use, Type, and Distribution Following Implementation of the Affordable Care Act

Background: Over half of all births in the United States are the result of unintended pregnancies. Nearly one half of those women are using contraception incorrectly, and the rest are not using it at all. A major barrier to the use of highly effective methods of contraception is cost. One of the major goals of The Patient Protection and Affordable Care Act (ACA) was to make highly effective contraceptives available to all women at no cost. Objective: To examine the changes in utilization and methods of contraception since the ACA was effected in 2012. Methods: Comparisons were made on summary data of contraception use from the National Survey of Family Growth (NSFG). Three time period (2002, 2006-2010, 2011-2013) were compared for changes in utilization and methods chosen. Data were analyzed by age, race, and education as detailed in the NSFG. Results: Overall utilization of contraceptives remained unchanged at 62% of reproductive aged women (15-44 years) and across the age, race and educational attainment. Contraceptive method of choice has changed, favoring long-acting reversible contraceptive (LARC) methods: IUD use increased from 2% to 10.3% overall and was the only method to increase across all variables. Conclusions: These early data show the ACA has had a small impact on contraceptive choice, yet the trend is in a positive direction toward the most effective methods. Unfortunately, Black women, who have the highest rate of unintended pregnancy, are still being left behind in utilization of contraception